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Anorexia Nervosa:  Treatment Efficacy of Cyproheptadine and Amitriptyline

Katherine Ann Halmi, MD; Elke Eckert, MD; Terence J. LaDu, MA; Jacob Cohen, PhD
Arch Gen Psychiatry. 1986;43(2):177-181. doi:10.1001/archpsyc.1986.01800020087011.
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• Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an antidepressant effect demonstrated by a significant decrease in the Hamilton depression ratings.

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